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Self-care patients weren’t completely on their own – any changes they made were part of a treatment plan previously approved by their doctors. But the patients didn’t need to consult their doctors every time they increased the dose if it was part of the original treatment plan.

Why self-management worked best is uncertain, but patients who participated were taking more medication than the others and were perhaps more vigilant than doctors treating the usual-care group, the study suggests.

It’s possible usual-care doctors had “clinical inertia” – a phenomenon described in other research showing that physicians often fail to increase blood pressure medication doses even when office measurements show patients’ levels are too high, said study author Richard McManus, a professor and researcher at the University of Oxford.

The study was published Tuesday in the Journal of the American Medical Association.

Nearly 1 in 3 U.S. adults have high blood pressure – measuring 140 over 90 or higher – but only about half of them have it adequately controlled, according to the Centers for Disease Control and Prevention. High blood pressure rates are similar in England, health surveys there have found.

The study involved 450 patients with previous heart trouble, strokes, diabetes or kidney disease, aged 70 on average, who were followed for a year.

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